2012 in Review

It's the time of year that many writers reflect on the major events of the past 365 days.  I'll let the journalists cover the impact of the election, the epidemic of senseless violence, and the scandals of infidelity.To me, there were 5 major healthcare IT events in 2012 that we need to recognize and celebrate:1.  EHR adoption became unstoppable - In 2010, the Beth Israel Deaconess Physician's Organization changed its bylaws to require...[Readmore]

A White Christmas on Unity Farm

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And to All a Good Night

It's Christmas Eve and we're gathered around the hearth at our farm awaiting the Christmas snowfall that is forecast tonight for New England.I've split logs from an oak tree that blew over during Hurricane Sandy and cut thin flakes from an old cedar tree that fell at the edge of our pasture.  The cedar's oils pop and crackle in the fire, so I only use small pieces at a time.    The room is filled with the scents of the balsam fir Christmas...[Readmore]

Building Unity Farm - Naming the Animals

I recently spoke with the owner of a 200 acre farm where he and his wife run a CSA, breed goats, and raise cattle.   As a vegan, I'm always interested in how farmers who raise livestock for meat address the issue of the emotional bond between the caregivers and the animals.One common theme I've heard is that farmers and their families do not name animals they intend to sell or process for meat.    It's really awkward to respond to...[Readmore]

The December HIT Standards Committee Meeting

The December HIT Standards Committee focused on the reality of implementing the Meaningful Use Stage 2 Standards and Certification rule in the real world of hospitals, clinician offices, and healthcare information exchanges.First, Liz Johnson and Cris Ross provided a detailed review of the 7 waves of certification test scripts.    We discussed several recommendations to clarify and streamline the testing process.   In early 2013, the...[Readmore]

Brainstorming About the Future of Clinical Documentation

In 2013, I'm focusing on 5 major work streams:*Meaningful Use Stage 2, including Electronic Medication Administration Records*ICD10, including clinical documentation improvement and computer assisted coding*Replacement of all Laboratory Information Systems*Compliance/Regulatory priorities, including security program maturity*Supporting the IT needs of our evolving Accountable Care Organization including analytics for care managementI've written about...[Readmore]

Creating a Mature Security Program

Last Wednesday I was in Washington DC speaking at the ONC annual meeting and the speaker who preceded me was Leon Rodriguez, Director of the Office of Civil Rights.  On Thursday, I was in Boston speaking at the HIMSS Privacy and Security Forum and the  speaker who preceded me was Leon Rodriguez.  Now that Leon and I are doing roadshows together, I have a broader understanding of the privacy and security enforcement goals of the Obama...[Readmore]

Building Unity Farm - The Unconditional Love of Dogs

As I've mentioned in previous posts, our male alpacas are guarded by two Great Pyrenees Mountain dogs,  Bundle (a one year old female) and Shiro (a 6 month old male).   Bundle is 70 pounds and not likely to grow much more.   Shiro is 70 pounds and likely to grow to 100 pounds.At the farm, we have a routine.   In the early morning, when we do chores (stock the hay feeders, fill water buckets, haul manure etc.) we give the dogs...[Readmore]

Interoperability Gets Real

Today I'm speaking at the ONC annual meeting as part of panel discussing interoperability.For years, patients, providers and payers have complained that EHRs "do not talk to each other"By 2014, I expect this issue to disappear.Why?Do I expect that every state and territory will have a robust, sustainable healthcare information exchange by 2014?  NoDo I expect that every provider will be connected to a Nationwide Health Information Network by...[Readmore]

Cool Technology of the Week

I've written several posts about security including identity management, role-based access control, and two factor authentication.As we work to follow best practices, I'm always interested in learning about emerging technologies.I was recently emailed about OneID as a means to secure identity using specifically registered devices.   Here's a technology overview.Here's the full story.The bottom line is that by using digital certificates placed...[Readmore]

Building Unity Farm - Preparing for Christmas on the Farm

This is our first winter on the farm and although we have prepared the barn, pasture, woodlot, coop, and animals for the cold weather  we do not yet have Christmas traditions at Unity.  This year, we have to make them.Using local materials from local vendors, we've added garlands of white pine and fir to the barn, pasture gate and house entryway.   We've hung wreaths on the sheds and added swags of juniper to our light posts.Mistletoe...[Readmore]

Creating Quantitative IT Governance

Over the past few months I've been talking to many industry leaders about the challenge of matching IT supply and demand.   Governance committees are essential but are not enough when the number of project requests is so large that they become difficult to triage.Objective, quantitative scoring criteria can help. Intel has implemented a Business Value Index that is based on numerical scoring ofCustomer needBusiness and technical risksStrategic...[Readmore]